Medical Economics - Analyst, Medical Economics

ArchWell Health • Nashville, TN

1d

About The Position

The Analyst, Medical Economics supports analytical needs across ArchWell Health’s Operations, Clinical, and Finance teams, with a focus on markets across Florida, the East, and the West regions. The role helps internal leaders understand trends, cost drivers, and financial performance using multiple data sources. It is described as a fast-paced position that supports personal development and growth.

The analyst analyzes claims, membership, and ADT data to identify emerging trends or issues related to medical care costs. The role works with finance and business leaders to establish benchmarks, monitor medical cost trends and variances, and track medical cost KPIs for markets. It also partners with market leaders to increase awareness of medical cost issues and communicates analytical results in an organized, visual, actionable way. Other duties and special projects may be assigned, with a focus on developing knowledge and skills.

Requirements

• Bachelor’s degree in STEM, such as Applied Math, Statistics, Actuarial Science, Economics, or a related field.
• 1–2 years of prior analyst experience with a health plan, ACO, RBE, or consulting firm focused on healthcare analytics, decision support, or medical economics.
• Proficiency in Microsoft Excel, including formulas, PivotTables, Power BI, graphing, and other reporting and presentation features.
• Proactive initiative in exploring and discovering opportunities to improve company performance through data analysis.
• Ability to establish trusting, professional relationships with colleagues.
• Effective organization skills and ability to work in a fast-paced, team-oriented environment.
• Financial and business acumen, problem-solving and analytical skills, and keen attention to detail and accuracy.
• Knowledge of healthcare and medical economics data, including hospital, physician, and ASC claims; utilization data; and healthcare industry coding systems such as ICD-10, CPT/HCPCS, Revenue Codes, MS/APR-DRGs, and APCs.
• Excellent verbal, written, and presentation communication skills using applications such as Microsoft Word, PowerPoint, and Excel.

Nice To Haves

• Experience in data mining and working with healthcare claims and enrollment data in large repositories and/or relational databases.
• SQL experience is strongly preferred.

Responsibilities

• Analyze claims, membership, and ADT data to identify early signs of trends or other issues related to medical care costs.
• Perform qualitative analysis to identify utilization- or rate-related cost drivers, solve business problems, and improve data-driven strategies and processes to improve financial results.
• Partner with finance and business leaders to create benchmarks for monitoring medical cost trends and variances.
• Track medical cost key performance indicators (KPIs) for markets.
• Build strong, trusting relationships with market leaders to support awareness of medical cost issues and challenges.
• Present analytical results in an organized, visual manner that communicates a meaningful, actionable story.
• Execute other duties and special projects as needed, focusing on knowledge and skills development.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level